The Washington Manual of Medical Therapeutics helps you diagnose and treat hundreds of medical conditions. Consult clinical recommendations from a resource that has been trusted on the wards for 50+ years. Explore these free sample topics:
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- NTM are ubiquitous environmental organisms that cause a spectrum of disease primarily involving the lungs (80%), skin and soft tissues, lymph nodes, and disseminated disease. Susceptibility testing and an infectious disease consultation are recommended to guide treatment. Different species are commonly associated with specific clinical presentations:
- Pulmonary infection: Mycobacterium avium complex (isolated in 85% of the cases), M. kansasii, and M. abscessus are the most common pathogens involved.
- Skin, soft tissues, and bone infection: M. fortuitum, M. chelonae, M. scrofulaceum, M. marinum (“fish tank granuloma”), and M. ulcerans (Buruli ulcer).
- Lymphadenitis: M. avium complex and M. scrofulaceum.
- Disseminated: M. avium, M. kansasii, M. abscessus, M. chelonae, and M. haemophilum (see Chapter 16, Sexually Transmitted Infections, Human Immunodeficiency Virus, and Acquired Immunodeficiency Syndrome).1
- Mycobacterium leprae is classified separately from the other NTM because of its potential for human-to-human transmission. Although, rarely seen in the United States, it is associated with exposure to armadillos. Clinically, typical findings include hypopigmented anesthetic skin lesions.